The Right to Pain Relief and Other Deep Roots of the Opioid Epidemic

Abstract The Right to Pain Relief and Other Deep Roots of the Opioid Epidemic aims to reach beneath popular narratives that blame profit-seeking pharmaceutical companies and healthcare practitioners for opioid overprescribing and the resulting epidemic of opioid addiction, overdose, and death. This book argues that the opioid epidemic arises from serious misunderstandings of both opioids and pain. Based on opioid use for acute pain, clinicians believed that opioids were specific “painkillers” that relieved pain but left the person alone. Recent research has shown that opioids have diverse functions within the human brain to modulate many forms of stress and support emotional function and socialization. We have also misunderstood the role of pain in human life. Over the past millennium, Western society has shifted from considering pain a religious problem, then a social problem, and now a medical problem. Innovations in the care of patients at the end of life led us to consider pain control to be an important medical responsibility independent of disease control, and to consider opioids to be safe and effective. Even though we understand chronic pain as a biopsychosocial condition, we have built mechanical causal models of chronic pain that support a moral model of pain as a form of passive and innocent suffering for which it is appropriate to claim a right to pain relief. To end our current opioid epidemic and prevent future epidemics, we need to reintegrate pain with the rest of human suffering as a necessary part of a full human life.